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CPT 69220: Debridement of Mastoidectomy Cavity
CPT code 69220 denotes debridement of the cavity left after a mastoidectomy, a follow-up surgical procedure used to remove debris and promote drying and healing of the mastoid cavity. This code is relevant nationally for otolaryngology practices and facilities that manage postoperative ear surgery patients, since some patients require one or more debridement sessions before the cavity stabilizes. The code applies to procedures typically performed in ambulatory surgical centers, hospital outpatient departments, or specialized clinic procedure rooms.
Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines clinical context for use of the code, common associated ICD-10 diagnoses relevant to ear conditions, related CPT codes for similar ear procedures, and typical billing considerations. Readers will find a clear description of the service represented by 69220, comparisons with related codes such as 69222 and 69210, and a concise summary of payer coverage patterns and policy considerations at a national level. The content is intended to clarify when 69220 is applicable, where the service is commonly provided, and what clinical scenarios typically generate use of the code.
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Billing Code Overview
CPT code 69220 describes a surgical debridement procedure in which the provider cleans and removes debris from the cavity created by a prior mastoidectomy. The procedure is typically performed when the post-mastoidectomy cavity requires repeated cleaning to promote drying and healing.
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Service type: Surgical debridement of a mastoidectomy cavity
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Typical site of service: Ambulatory surgical center or hospital outpatient setting, and occasionally performed in an otolaryngology clinic procedure room when clinically appropriate
National Reimbursement Benchmarks
Commercial averages sit above Medicare for CPT 69220: Blue Cross Blue Shield and BUCA show notably higher means versus Medicare’s mean of $80.9. BUCA’s mean is $150.7, roughly $69.8 higher than Medicare, while Blue Cross Blue Shield’s mean of $183.1 is about $102.2 above Medicare, indicating commercial payers commonly reimburse substantially more than Medicare for this code.
Dispersion across payers varies: Blue Cross Blue Shield has a P75–P25 range of $83 (from $143.8 to $222.1), UnitedHealth Group’s range is $85.1 (from $78.9 to $164.0), and Cigna’s range is $92.1 (from $72.5 to $164.6). Aetna shows a tighter spread of $48.0 (from $36.3 to $86.0). BUCA’s interquartile range is $77.1 (from $109.0 to $186.1). Overall, Cigna displays the widest IQR and Aetna the tightest among these payers.